Chess-Based Cognitive Remediation Training - A Candidate Add-On-Treatment for Alcohol Use Disorder?

AimsAlcohol use disorder (AUD) is associated with deficits in various cognitive functions which can impair conventional treatment and increase relapse risk. This longitudinal quasi-randomized controlled study investigated chess-based cognitive remediation training (CB-CRT) as add-on therapy to improve cognitive control and psychosocial outcomes compared to standard rehabilitation. Materials and methodsThe study was conducted from April 2022 to November 2023 among AUD patients in long-term residential rehabilitation. Participants in the experimental group attended 90-minute CB-CRT group sessions twice weekly for six weeks between April 2022 and April 2023, conducted by clinical staff using the "Entrenamiento cognitivo a traves del ajedrez" (ECAM(R)) method. Assessments were conducted at baseline (T1, day 1), post-intervention (T2, day 42), and on day 126 (T3). Primary outcomes were training effects in sustained attention, decision-making, and set shifting (cognitive flexibility). Abstinence, craving, subjective well-being, and liking of the intervention were assessed at all timepoints (T1, T2, and T3). ResultsFifty-one participants completed two timepoints (T2 six weeks after T1): n = 32 allocated to the experimental group and n = 19 to the control group (no chess intervention). The CB-CRT group showed significant improvement in sustained attention (MDiff = 8.26) and a positive, non-significant trend in cognitive flexibility at T2. No significant effects were found for short-term abstinence, craving, or mood at T3 (day 126). A significant increase in general life satisfaction was observed in the CB-CRT group at T2 (MDiff = 3.78), though not sustained at follow-up. The intervention was well accepted, with increased recommendation scores between T1 and later assessments. ConclusionsCB-CRT improved sustained attention and general life satisfaction, and was well accepted. However, the relatively small sample size limited statistical power and detection of further effects. A larger replication study could enhance generalizability and clarify impacts on cognitive control, relapse, and relapse timing.